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Transitional care program

River Falls Area Hospital Transitional Care also known as Swing Bed (a Medicare term), is for patients that need additional therapies or nursing care to fully recover following a hospitalization.

The personalized services provided during Transitional Care are based on individual needs and preferences, enabling you to return home as soon as possible.

Medicare will cover the cost for these services when specific criteria are met. In addition, private insurance may also pay for these services. 

Learn more

What to expect from the program

A transitional care stay includes 24-hour access to hospital level nursing staffing to keep you safe and meet your needs. Our onsite physician, therapy, radiology, laboratory, pharmacy and social services teams will work with you to establish goals for your recovery. Throughout your stay, your progress will be evaluated to ensure you are meeting your rehabilitation goals. 

The nursing staff will encourage you to do as much as you can for yourself to improve your strength, endurance and independence. It is important for you to regain the level of activity and confidence you need to manage safely at home.


  • Large private rooms with private baths
  • Cable TV
  • Pastoral care services
  • Guest Wi-fi

Our private in room service for patients and their families allows you to choose your meals from a restaurant style menu. Meals are prepared by our in-house chef and baker, who receive high marks in patient satisfaction surveys for food quality. A nominal fee is charged for visitors or family member meals. 

Clothing and personal items
Patients are encouraged to dress in their own comfortable clothing. Hospital gowns and robes will be provided if needed. Please bring your own personal items such as toothbrush and toothpaste, combs, shampoo, denture cup and cleaners, shaving items, etc. Good walking shoes (non-skid, no heels) are recommended. 

Admission Requirements 

  1. You must have been a patient in an acute care hospital for three days within the last thirty days prior to admission

    and require
  2. Skilled nursing service (examples: IV therapy, daily injections, extensive wound care teaching, diabetes management)

  3. Skilled rehabilitation services (examples: physical therapy for ambulation or occupational therapy for management of daily activities)

Medicare information

  1. If daily improvement is being made, Medicare will cover the first twenty days and will reimburse the hospital.
  2. For days twenty-one through one hundred, you or your co-insurance will be responsible for paying the deductible as long as you meet Medicare criteria.
  3. Medicare discontinues reimbursement when a patient no longer meets Medicare criteria for skilled services. When this occurs, the patient becomes financially responsible. 

Discharge Planning
During your stay, an active evaluation process involving the patient, family members, physician, social services, nursing and therapy staff will help determine when you can be safely discharged home. Therapeutic home visits may be scheduled to evaluate your ability to manage your home environment. 

Upon discharge, outpatient rehabilitative care can be provided Courage Kenny Rehabilitation Institute.  For those needing additional home care upon discharge, our staff will help coordinate home care services.

What's the next step?

Give our swing bed program care  (transitional care) team a call at 715-307-6139 to find out more. We will work with you and your physician to determine your suitability for this swing bed care (transitional care) option. We are happy to work with your insurance company to determine if the program is a covered benefit for you.

You can also reach an RN Care Coordinator at 715-307-6139 and the Nurse's station at 715-307-6100.